Depending on the stage of gum disease, we often perform laser pocket disinfection. We use a laser to remove harmful bacteria deep within the periodontal pockets. This procedure significantly reduces, if not completely eliminates gum inflammation, bleeding, pain, or discomfort during flossing. In some cases, the laser treatment will also eliminate bad breath. 

Laser treatment allows for a substantial reduction of bacteria in the gums without requiring any surgery or cutting. LPD is a highly effective treatment that is painless and takes about 10-15 minutes to perform. 

Scaling & root planing is a common non-surgical treatment for gum disease that is a combination of two procedures. This provides a very deep clean to reverse the onset of gum disease. 

Scaling involves removing built-up plaque below the gum line using either a manual scraping instrument or an ultrasonic tool. Root planing is done by gently sanding your teeth, removing rough spots on the tooth surfaces and roots, which tend to harbor bacteria. We use both mechanical tools to manually scrape away debris and an ultrasonic tool (a vibrating wand) that thoroughly breaks up plaque. We find that the ultrasonic method tends to be less uncomfortable. 

Root planing and scaling fight gum disease in two ways: 

1. By removing the plaque on your teeth and deep down in your gums 
2. Smoothing out areas of your teeth where bacteria thrive 

We recommend this procedure when we see any significant sign of gum disease to lower the risk of any tooth loss, avoid advancing disease, and prevent future surgical procedures. 

Periodontal disease can create a loss of gum tissue and weaken the strength of natural teeth, usually leaving them loose. We use a technique called dental splinting to attach weak teeth together, creating a single unit to increase stability and strength so that natural teeth can last longer.  We use composite material to attach the loose teeth to adjacent stable teeth; the material we use is light and durable and does not add any strain to the supporting teeth. 

Dental splinting is an excellent non-surgical procedure that is effective in reversing periodontal damage. When periodontal disease has advanced, and bone loss occurs, it is challenging to save the teeth. Loose teeth are a result of the loss of supporting bone around the roots of the teeth and they are often painful. Splinting is an excellent and effective way to keep the active periodontal disease under control and reduce pain.

There are many causes of receding gums including, but not limited to: 

• periodontal disease 
• overly aggressive brushing 
• orthodontic treatment 
• the shape of your teeth and roots 
• and improper tooth alignment. 

Fortunately, this recession is very treatable if caught before serious consequences occur. Dr. Malpeso has mastered the pinhole surgical technique* and uses it to treat cases of gum recession. It replaces the need for traditional gum grafting, in which the periodontist takes a flap of donor tissue, usually from the palate, and sutures it to the existing gum tissue. While that procedure is effective, it requires significant cutting, stitching, and healing time. 

The pinhole technique is much less invasive than gum grafting and the results are natural looking and long lasting. Dr. Malpeso uses a needle to make a small hole in the gum tissue, through which he will use specialized tools to gently loosen the gums and reposition the gum line. Since there is no need for donor tissue or sutures, recovery time is short. 

*pinhole surgical technique:

When you lose your teeth, several things begin to happen. Aside from the obvious impact on the appearance of your smile, tooth loss will affect how you eat, speak, and will weaken the gums and bones, gradually losing mass and changing shape. This can cause healthy teeth to shift out of alignment and change your facial appearance. If too much bone mass is lost, it will make treatment with dental implants more difficult. 

We use bone grafting to restore missing bone mass and provide a solid, healthy structure for implants. During this procedure, we take bone mass from elsewhere in your body, or from a donor, and place it into the weak areas of your jaw. Your natural bone then fuses to and around the graft material, restoring strength to your jaw and ensuring successful integration for implants.

Implants are an excellent option because they do not rely on neighboring teeth for support and can maintain the integrity of the overall dental structure. Implant technology permanently anchors the denture and creates stability and permanence to restore your ability to speak and eat normally. Implants give support to facial musculature and eliminate the inconvenience and discomfort of ill-fitting prostheses.

Malocclusion -- when teeth do not come together correctly -- affects the jaw and causes various dental issues. It can develop over time from the general wearing away of the teeth or from injury, however, sometimes it occurs by how the teeth naturally developed. 

Patients with malocclusion often experience severe headaches, neck aches, and tooth pain since the muscles of the jaw and neck are often tense. Many patients also develop bruxism, or teeth grinding, consequences of which are loss of tooth structure and receding gums. 

If malocclusion and bruxism go untreated, patients may also develop temporomandibular joint (TMJ) issues. In these cases, we recommend an Occlusal Adjustment procedure, or bite adjustment. This procedure involves removing tiny interferences that prevent teeth from coming together.